RT Journal Article
SR Electronic
T1 Cerebrovascular Anomalies in the Fetus
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 231
OP 239
DO 10.3174/ajnr.A8377
VO 46
IS 2
A1 Jaimes, Camilo
A1 Ferraciolli, Suely Fazio
A1 Orbach, Darren B
YR 2025
UL http://www.ajnr.org/content/46/2/231.abstract
AB SUMMARY: Four distinct vascular anomalies can be seen to affect the brain on fetal imaging: vein of Galen malformations, nongalenic arteriovenous pial fistulas, dural sinus malformations, and intracranial venous malformations. These congenital disorders affect the arteries and veins of the developing brain and are rarely seen beyond the neonatal stage. The 4 fetal cerebrovascular anomalies are associated with quite disparate natural histories and prognoses. MRI plays a pivotal role in the evaluation of fetuses with these conditions because of its ability to definitively establish the diagnosis, to detect subtle parenchymal injuries, to delineate the course of abnormal vessels in detail and to some extent the nature of vascular flow, and to identify ischemic, thrombotic, and hemorrhagic complications. Recently, an investigational transuterine embolization procedure targeted at treating fetuses with vein of Galen malformations who are at high risk for neonatal decompensation has emerged as a promising alternative to expectant management and postnatal embolization, with imaging being used to identify suitable patients for the intervention and in preprocedural planning. This manuscript reviews the essential imaging and clinical features of these 4 fetal neurovascular anomalies and underscores the practical aspects related to counseling, prognosis, and the multidisciplinary management of these entities.b-SSFPbalanced steady-state free precessionDSMdural sinus malformationicVMintracranial venous malformationRASA1RAS P21 protein activator 1SSFSEsingle-shot fast spin-echoVOGMvein of Galen malformation